401710931-9-28-2021-17-CC-EBAY-C7AU5K-20210928151652

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401710931
Report Date: 09/28/2021
Date Signed: 09/28/2021 03:17:01 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	ARROYO GRANDE MONTESSORI SCHOOL		FACILITY NUMBER:	401710931
ADMINISTRATOR:	MICHAEL MILLER		FACILITY TYPE:	850
ADDRESS:	216 OAK STREET		TELEPHONE:	(805) 473-2979
CITY:	ARROYO GRANDE	STATE: CA	ZIP CODE:	93420
CAPACITY:	23	CENSUS: 11	DATE:	09/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Elizabeth Silva		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 9/28/21, at 1:45 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Inspection of the abovementioned Child Care Center (CCC). LPA met with Elizabeth Silva , Assistant Director of the CCC and explained the purpose of the inspection. LPA, in the company of Assistant Director, toured the interior and exterior of the CCC. The CCC operates from 7:30 AM to 3:30 PM, Monday - Friday. The preschool uses a great room and an outdoor play area for child care services. LPA observed 11 children on site at the time of the inspection, along with one staff member (cleared and associated) providing supervision. LPA observed the CCC's classrooms to be clean and well organized. The classroom has age appropriate toys and furnishings available for children in care. LPA observed the restroom area used by children in care to be clean and free of toxins. The CCC has an operable refrigerator which contained food and beverages. LPA notes children in care bring lunches from their homes, while the CCC provides snacks. CCC staff ensure lunches brought from home contain food from the essential food groups and are free of junk foods. The CCC affords the children water both inside the CCC and in the exterior. LPA observed a facility menu posted along side required licensing documents near the CCC's main entry/exit. The CCC uses an electronic sign in and sign out system for the facility (the Pro Care System). LPA reviewed a sampling of entries in the Pro Care system which were completed satisfactory. LPA observed a carbon monoxide detector in the CCC which was tested (2:10 PM) and found to be operable. Disinfectants and cleaning solutions are observed on an elevated shelf in the CCC's restroom area which is inaccessible to children in care. The CCC currently has no medication on site, however when medication is on the premises medication is stored in the teacher's restroom area which is exclude from care and inaccessible to children. The CCC’s outdoor playground area, which is comprised of natural grass, and rubber chip footing is (CONT 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: ARROYO GRANDE MONTESSORI SCHOOL	FACILITY NUMBER: 401710931
	VISIT DATE: 09/28/2021

NARRATIVE

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enclosed by chain linked fencing. The fence’s entry/exit gates are secured. LPA observed age appropriate toys and play equipment in the play area. The toys and play equipment are in suitable condition and free of sharp, loose or pointed objects. LPA observed the play structures in the playground area have adequate cushioning materials (i.e. rubber chips) to absorb falls and shade covering in the area provided by tree and building overhangs. LPA observed a shed in an excluded area of the outdoor which contains CCC supplies. The shed is secure. No bodies of water were observed on site. Waste receptacles with tight fitting covers were observed throughout the center.

A sampling of staff and children's records were reviewed. The children’s records were complete and found to contain emergency contact information and well as immunization records. Staff records were reviewed and contain current pediatric CPR/First Aid (EMSA) as well as current Mandated Reporter certificates. Assistant Director informed LPA no firearms or ammunition is stored on site.

This CCC is not currently providing Incidental Medical Services (IMS). For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA discussed COVID 19 guidance and best practices with the Assistant Director. Assistant Director is reminded that it is Assistant Director and facility's responsibility to know the regulations for a CCC which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

LIC809 (FAS) - (06/04)

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